The Cecil G Sheps Center and the Program on Health Outcomes of the University of North Carolina propose to establish a Center of Excellence on Overcoming Racial Disparities (CEORHD). The CEORHD will focus the expertise of a diverse and unique research community on causes and contributing factors leading to inequalities in access to and outcomes of care. We will work with two historically black North Carolina universities, NC Central and Shaw University, in both the research projects and through research training linkages. We will establish two core groups: the Administrative and Methods Core and the Data Management Core. We will be assisted by an external advisory board as well an internal group to aid in training issues. Over the 5 years of the proposed program project, we will complete seven research projects. These projects will share research infrastructure and contribute to research seminars at UNC, NCCU, and Shaw. Our clinical area of interest is the understanding and elimination of health disparities for adult cancer and other chronic illnesses among black adults, with a special focus on rural black populations: (1) racial disparities in rectal cancer (community-based case-control study); (2) racial differences in prostate cancer treatment outcomes (community- based case-case study assessing differences between prostate cancer in whites and blacks); (3) interventions to reduce disparities between black and white women in physicians' recommendations for mammography (community-based RCT); (4) community-based disease management for (5) service coordination for patients with HIV and STD infections (study of administrative coordination among agencies in rural areas and its relationship to health disparities); (6) racial concordance and outcomes of care for black patients with high blood pressure (secondary data analysis); and (7) measurement of functioning and well-being in minority populations (secondary data analysis). Taken together, these projects will substantially advance our understanding of both the etiology of and redress for current racial disparities in health.